Intelligence Quotient Scores Research Articles

ADMINISTERING INTRAVITREAL BEVACIZUMAB FOR RETINOPATHY OF PREMATURITY: 8-Year Cognitive Outcomes In A Prospective Cohort.

Determine whether intravitreal injection of bevacizumab exerts long-term effects on neurodevelopmental outcomes in children with retinopathy of prematurity (ROP) when reaching the age of 8 years. In total, 277 children were enrolled. Patients were stratified into full-term, preterm without ROP, ROP without treatment, or ROP with treatment groups, based on gestational age and ROP status. Children under the gestational age of 37 weeks were considered premature. Patients' cognitive outcomes were evaluated using a full-scale intelligence quotient (full score and percentile) generated by the Wechsler Intelligence Scale for Children-Fourth Edition every 1 year to 2 years. At the mean age of 7.8 years, ROP without and with treatment groups demonstrated lower full-scale intelligence quotient scores and percentiles, compared with full-term and premature groups (both P < 0.05). Full-scale intelligence quotient scores and percentiles did not significantly differ between patients who received different treatments for ROP (full score P = 0.19; percentile P = 0.37). After adjusting for gestational age, logMAR best-corrected visual acuity was negatively associated with full-scale intelligence quotient scores ( P = 0.0008) and percentiles ( P = 0.0002). At the mean age of 8 years, patients with ROP undergoing injection of bevacizumab did not exhibit worse cognitive outcomes than those who underwent laser photocoagulation or both treatments. Gestational age and best-corrected visual acuity correlated with cognitive development in children.

Risk factors for Ascaris lumbricoides infection and its association with nutritional status and IQ in 14-Year old adolescents in Chitwan, Nepal

Inconsistent results have been obtained from studies investigating the association between soil-transmitted helminths (STHs) and nutritional status and cognitive outcomes. This study aimed to investigate the influence of STHs and nutritional status on the intelligence quotient (IQ) of adolescents in the Chitwan Valley, Nepal. In this birth cohort study from the Chitwan district of Nepal, 74 cohort participants were followed up after 14 years. The presence and egg density of the STHs were investigated following the Kato–Katz method. Full-scale IQ was evaluated using the Wechsler Abbreviated Scale of Intelligence-II (WASI-II). Multivariate regression analysis was also conducted to examine the associations of STHs and nutritional status with IQ scores, adjusting for adverse childhood experiences (ACE) and demographic and socioeconomic factors. The only STHs detected was for Ascaris lumbricoides, which was detected in 16% (12/74) of the study participants. Similarly, 16% (12/73) of participants reported undernutrition (body mass index (BMI) Z score<-2SD), and 33% (25/74) of participants had a developmental deficit (WASI II FSIQ < 69). There were no significant associations between the presence of A. lumbricoides or egg density and IQ scores. However, undernutrition (BMIZ<-2SD) increased the odds of a developmental deficit according to both univariate and adjusted multivariate models [i.e., adjusted odds ratio (aOR) 9.41; 95% CI (2.23 to 39.80)]. While the study primarily examines the association of STHs and nutritional status with IQ, it is important to note that adolescents with educated mothers or higher incomes also showed better cognitive development. The prevalence of undernutrition and associated developmental deficits characterized by an IQ < 69 was alarmingly high in this cohort of adolescents from Chitwan, Nepal. Despite the high prevalence of A. lumbricoides, its infection was not identified as significantly associated with cognition. However, it is noteworthy that a consistent favorable impact of an enriching postnatal environment, approximated by maternal education and family income, may improve neurodevelopmental indicators.

Revealing Cultural Dynamics in WAIS-IV Performance: a Comparative Analysis of Age Cohorts in Taiwanese and U.S. Populations.

This study examined the relationship between culture and cognitive abilities by comparing WAIS-IV subtests, index scores, and Full-Scale Intelligence Quotient (FSIQ) scores across various age groups in the Taiwanese and U.S. populations. The Taiwanese and U.S. versions of WAIS-IV are comprehensively compared, examining subtest items, psychometrics, and sample characteristics. Scaled scores are compared by extracting raw scores with a scaled score of 10 from each subtest scale in the Taiwanese version and applying U.S. age norms to acquire U.S. scaled scores. Despite the mean FSIQ score closely aligning with the U.S. sample, notable discrepancies are evident in the Taiwanese Verbal Comprehension Index (VCI) score, potentially influenced by cultural fairness of the tests. Significant variations are observed among age cohorts in the Taiwanese sample, with younger individuals excelling in Processing Speed Index, Working Memory Index, Perceptual Reasoning Index, and FSIQ, while maintaining comparable VCI scores to their U.S. counterparts. Conversely, older cohorts demonstrate lower performance across various domains, except for visuospatial reasoning and organizational skills, compared to their U.S. counterparts. These subtest variations robustly correlate with educational disparities between the Taiwanese and U.S. samples. Despite the similarity in factor structures between the Taiwanese and U.S. versions of WAIS-IV, this study reveals cultural bias in both verbal and non-verbal subtests. The study highlights the intricate interplay among cognitive processing styles, cultural influences, and educational factors contributing to performance disparities.

Associations of fetal and infant growth patterns with behavior and cognitive outcomes in early adolescence

AbstractBackgroundFetal life and infancy might be critical periods for brain development leading to increased risks of neurocognitive disorders and psychopathology later in life. We examined the associations of fetal and infant weight growth patterns and birth characteristics with behavior and cognitive outcomes at the age of 13 years.MethodsPopulation‐based prospective cohort study from fetal life until adolescence. Pregnant women with a delivery date between April 2002 and January 2006 were eligible. Follow‐up measurements were available for 4716 children. Fetal weight was estimated in the second and third trimesters of pregnancy by ultrasonography. Infant weight was measured at birth and at 6, 12, and 24 months. Fetal and infant weight acceleration or deceleration were defined as a change in SD greater than 0.67 between time points. Total, internalizing and externalizing problems and attention‐deficit hyperactivity disorder (ADHD) symptoms were measured using Child Behavior Checklist (CBCL/6–18), autistic traits by the Social Responsiveness Scale (SRS) and intelligence quotient (IQ) by the Wechsler Intelligence Scale for Children‐Fifth Edition (WISC‐V).ResultsOne week longer gestational age at birth was associated with a −0.03 SDS (95% Confidence Interval (CI): −0.04, −0.01) lower total behavior problems score, a −0.02 SDS (95% CI: −0.04, −0.01) lower ADHD symptoms score. Also an increase in birth weight of 500 g was associated with a lower odds of having high externalizing problems (OR 0.92 (95% CI: 0.86, 0.98) and of having a low IQ score (OR 0.79 (95% CI: 0.71, 0.88). Compared to children with normal fetal and infant growth, those with accelerated fetal and infant growth had a 0.27 SDS higher IQ (95% Confidence Interval 0.11, 0.44).ConclusionsBoth fetal and infant weight development are associated with behavioral and cognitive outcomes in early adolescence. Follow‐up studies are needed to assess whether these associations link to later life mental health outcomes.

Item response theory-based continuous test norming.

In norm-referenced psychological testing, an individual's performance is expressed in relation to a reference population using a standardized score, like an intelligence quotient score. The reference population can depend on a continuous variable, like age. Current continuous norming methods transform the raw score into an age-dependent standardized score. Such methods have the shortcoming to solely rely on the raw test scores, ignoring valuable information from individual item responses. Instead of modeling the raw test scores, we propose modeling the item scores with a Bayesian two-parameter logistic (2PL) item response theory model with age-dependent mean and variance of the latent trait distribution, 2PL-norm for short. Norms are then derived using the estimated latent trait score and the age-dependent distribution parameters. Simulations show that 2PL-norms are overall more accurate than those from the most popular raw score-based norming methods cNORM and generalized additive models for location, scale, and shape (GAMLSS). Furthermore, the credible intervals of 2PL-norm exhibit clearly superior coverage over the confidence intervals of the raw score-based methods. The only issue of 2PL-norm is its slightly lower performance at the tails of the norms. Among the raw score-based norming methods, GAMLSS outperforms cNORM. For empirical practice this suggests the use of 2PL-norm, if the model assumptions hold. If not, or the interest is solely in the point estimates of the extreme trait positions, GAMLSS-based norming is a better alternative. The use of the 2PL-norm is illustrated and compared with GAMLSS and cNORM using empirical data, and code is provided, so that users can readily apply 2PL-norm to their normative data. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Electroencephalographic changes in children with attention deficit hyperactivity disorder

BackgroundAttention deficit hyperactivity disorder (ADHD) is the most prevalent psychiatric disorder in children who experience delayed language development. This work aimed to study electroencephalographic (EEG) changes in children with ADHD and establish a strategy for prompt identification and suitable management in the future.MethodsThis descriptive cross-sectional study was conducted on 100 children aged between 5 and 12 years old, both sexes, diagnosed with ADHD according to DSM-V Criteria, diagnosed as ADHD children with the Arabic version of Conner’s Parent Rating Scale. Psychometric evaluation by intelligence quotient (IQ) using Stanford Binet Intelligence test. The Receptive Expressive Arabic Language Scale was used to assess language profile.ResultsThere was a significant negative correlation between the severity of ADHD and IQ scores. There was an insignificant negative correlation between ADHD and scaled receptive language score and scaled expressive language score. There was an insignificant positive correlation between ADHD and scaled expressive language score. There was a significant difference between EEG changes and combined subtype of ADHD and scaled score of receptive language (P < 0.05). There was an insignificant difference between (EEG changes and language development), the scaled score of expressive, total language, and the scaled score of language.ConclusionsEEG has clinical utility in the diagnosis of ADHD. The results of EEG analysis in children with ADHD have been quite important, and this novel methodology could offer supplementary factors to strengthen its diagnostic impact.

Prediction of individual performance and verbal intelligence scores from resting-state fMRI in children and adolescents.

The neuroimaging basis of intelligence remains elusive; however, there is a growing body of research employing connectome-based predictive modeling to estimate individual intelligence scores, aiming to identify the optimal set of neuroimaging features for accurately predicting an individual's cognitive abilities. Compared to adults, the disparities in cognitive performance among children and adolescents are more likely to captivate individuals' interest and attention. Limited research has been dedicated to exploring neuroimaging markers of intelligence specifically in the pediatric population. In this study, we utilized resting-state functional magnetic resonance imaging (fMRI) and intelligence quotient (IQ) scores of 170 healthy children and adolescents obtained from a public database to identify brain functional connectivity markers associated with individual intellectual behavior. Initially, we extracted and summarized relevant resting-state features from whole-brain or functional network connectivity that were most pertinent to IQ scores. Subsequently, these features were employed to establish prediction models for both performance and verbal IQ scores. Within a 10-fold cross-validation framework, our findings revealed that prediction models based on whole-brain functional connectivity effectively predicted performance IQ scores( ) but not verbal IQ scores( ). Results of prediction models based on brain functional network connectivity further demonstrated the exceptional predictive ability of the default mode network (DMN) and fronto-parietal task control network (FTPN) for performance IQ scores ( ). The above findings have also been validated using an independent dataset. Our findings suggest that the performance IQ of children and adolescents primarily relies on the connectivity of brain regions associated with DMN and FTPN. Moreover, variations in intellectual performance during childhood and adolescences are closely linked to alterations in brain functional network connectivity.

Sex-Specific Complement and Cytokine Imbalances in Drug-Resistant Epilepsy: Biomarkers of Immune Vulnerability.

Drug-resistant epilepsy (DRE) poses significant challenges in treatment and management. While seizure-related alterations in peripheral immune players are increasingly recognized, the involvement of the complement system, central to immune function, remains insufficiently explored in DRE. This study aimed to investigate the levels of complement system components and their association with cytokine profiles in patients with DRE. We analyzed serum samples from DRE patients (n = 46) and age- and sex-matched healthy controls (n = 45). Complement components and cytokines were quantified using Multi- and Single-plex ELISA. Statistical analyses examined relationships between complement molecules, cytokines, and clinical outcomes including epilepsy duration, Full-Scale Intelligence Quotient (FSIQ) scores, and age. We found common alterations in all DRE cases, including significant complement deficiencies (C1q, Factor H, C4, C4b, C3, and C3b/iC3b) and detectable bFGF levels. DRE females showed significantly lower levels of TNFα and IL-8 compared to healthy females. We observed a trend towards elevated CCL2 and CCL5 levels in DRE males compared to healthy males. These findings suggest potential sex dimorphism in immune profiles. Our analysis also indicated associations between specific complement and inflammatory markers (C2, IL-8, and IL-9) and Full-Scale Intelligence Quotient (FSIQ) scores in DRE patients. Our study reveals sex-specific peripheral complement deficiencies and cytokine dysregulation in DRE patients, indicating an underlying immune system vulnerability. These findings provide new insights into DRE mechanisms, potentially guiding future research on complement and cytokine signaling toward personalized treatments for DRE patients.

Neuropsychiatric comorbidities in adult patients with new-onset epilepsy

BackgroundNeuropsychiatric comorbidities in adult patients with new-onset epilepsy in our university hospitals has not been assessed, so the purpose of this study was to identify the neuropsychiatric comorbidities in adult patients with new onset epilepsy in our university hospitals. We recruited one hundred patients, assessed them clinically, radiologically, electrophysiologically, and we performed Wechsler Adult Intelligence Scale Fourth Edition (WAIS-IV), Liverpool Seizure Severity Scale (LSSS), Generalized Anxiety Disorder 7-item (GAD-7) scale, Beck’s Depression Inventory II (BDI II) and Quality of Life In Epilepsy-10 Questionnaire (QOLIE-10) to assess cognitive function, seizure severity, anxiety, depression, and quality of life of the patients, respectively.ResultsOlder adult age group had higher LSSS than other groups. Middle-aged adults’ group had higher WAIS-IV full scale Intelligence Quotient (IQ) score and lower GAD-7 scale scores than other age groups. Patients regularly on more than one anti-seizure medication had lower IQ results, more seizure severity, depression, anxiety and worse quality of life than those on monotherapy. Males had slightly higher IQ scores. Patients with moderate and severe BDI-II score had significantly higher rate of uncontrolled seizures, higher seizures’ frequency, more abnormal EEG and were regularly on valproate at significantly higher rates as compared to those with minimal BDI-II score. Patients with moderate anxiety were significantly older than those with normal and severe anxiety. Patients with severe anxiety had higher rate of family history of epilepsy, higher rates of uncontrolled seizures and higher seizures’ frequency as compared to those with mild and moderate anxiety. Patients with mild, moderate, and severe score on GAD-7 had more abnormal EEG as compared to those with normal GAD-7 score. Patients with severe and very severe seizures had significantly higher levels of anxiety, depression and impaired quality of life than those with mild and moderate seizure severity.ConclusionsMost patients with epilepsy had psychiatric comorbidities such as depression and anxiety which strongly reduce their quality of life and interfere with their compliance to anti-seizure medication. Males had slightly higher Intelligence Quotient (IQ) scores on WAIS-IV. Moreover, patients regularly taking more than one anti-seizure medication had a statistically significantly lower IQ score, more seizure severity, higher Beckʼs depression inventory II score, higher generalized anxiety disorder 7-item scale score, and worse quality of life than those on monotherapy.

The association between perinatal depressive symptoms and child neurodevelopment

BackgroundPerinatal depression has been suggested to adversely impact child neurodevelopment. However, the complexity of the early childhood environment challenges conclusive findings. ObjectiveTo evaluate whether there is an association between perinatal depressive symptoms and child intelligence quotient (IQ) at 5 years of age. Study DesignSecondary analysis of an ancillary study to a multicenter randomized trial of thyroxine therapy for pregnant individuals with subclinical hypothyroidism. Dyads of infants and birthing parent, with completed Center for Epidemiological Studies-Depression (CES-D) screens during pregnancy and postpartum and child neurodevelopment testing completed at five years of age (n=209) were included. CES-D screening was performed at 11–20 weeks, 34–38 weeks, and one-year postpartum. Depressive symptoms were categorized as antenatal (i.e., a positive screen at any point during pregnancy) or postpartum. The primary outcome was child IQ score < 85 at 5 years of age using the Wechsler Preschool and Primary Scale of Intelligence III (WPPSI-III) Full Scale test. Secondary outcomes included other assessments of childhood neurodevelopment. Bivariable analyses and multivariable logistic regressions were utilized. ResultsOf the 209 birthing people included, 72 (34%) screened positive for depression during pregnancy and 32 (15%) screened positive one year postpartum. Children born to individuals with a positive antenatal depression screen had a higher odds of IQ < 85 at 5 years of age compared with children born to individuals with a CES-D < 16 (35% vs. 18%, OR 2.4, 95% CI 1.2–4.7). Similar findings were seen for children born to individuals with a positive postpartum depression screen (47% vs. 21%, OR 3.3, 95% CI 1.5–7.3). These associations did not persist in multivariable analyses that controlled for social determinants of health and clinical characteristics (adjusted odd ratio [aOR] 1.4, 95% CI 0.7–3.1; aOR 2.1, 95% CI 0.9–5.1, for antenatal and postpartum depressive symptoms, respectively). Similar findings were observed for other adverse neurodevelopmental outcomes. ConclusionsHaving a positive perinatal depression screen was not associated with child cognitive outcomes after controlling for covariates including social determinants of health.

Specific EEG resting state biomarkers in FXS and ASD

BackgroundFragile X syndrome (FXS) and autism spectrum disorder (ASD) are neurodevelopmental conditions that often have a substantial impact on daily functioning and quality of life. FXS is the most common cause of inherited intellectual disability (ID) and the most common monogenetic cause of ASD. Previous literature has shown that electrophysiological activity measured by electroencephalogram (EEG) during resting state is perturbated in FXS and ASD. However, whether electrophysiological profiles of participants with FXS and ASD are similar remains unclear. The aim of this study was to compare EEG alterations found in these two clinical populations presenting varying degrees of cognitive and behavioral impairments.MethodsResting state EEG signal complexity, alpha peak frequency (APF) and power spectral density (PSD) were compared between 47 participants with FXS (aged between 5–20), 49 participants with ASD (aged between 6–17), and 52 neurotypical (NT) controls with a similar age distribution using MANCOVAs with age as covariate when appropriate. MANCOVAs controlling for age, when appropriate, and nonverbal intelligence quotient (NVIQ) score were subsequently performed to determine the impact of cognitive functioning on EEG alterations.ResultsOur results showed that FXS participants manifested decreased signal complexity and APF compared to ASD participants and NT controls, as well as altered power in the theta, alpha and low gamma frequency bands. ASD participants showed exaggerated beta power compared to FXS participants and NT controls, as well as enhanced low and high gamma power compared to NT controls. However, ASD participants did not manifest altered signal complexity or APF. Furthermore, when controlling for NVIQ, results of decreased complexity in higher scales and lower APF in FXS participants compared to NT controls and ASD participants were not replicated.ConclusionsThese findings suggest that signal complexity and APF might reflect cognitive functioning, while altered power in the low gamma frequency band might be associated with neurodevelopmental conditions, particularly FXS and ASD.

Abstract P347: Association between Blood Pressure, Left Ventricular Structure and Cognitive Function: Evidence from a Cohort Study in Preschool-aged Children

Objective: Serving as a common hypertensive target organ damage, left ventricular (LV) structure alteration has been found to be associated with cognition decline in the elderly. However, its mediating role in the association between decreased cognitive function and elevated blood pressure (BP) remains controversial, owing to several inherent confounder in adults that could distort observed associations. The study was first known conducted to examine the association between LV structure, BP and cognitive function in preschool-aged children, a population without disturbance of various cardiovascular risk factors. Methods: This study included 1279 children from Shanghai Birth Cohort (SBC) during 2018 to 2021. Using the Wechsler Preschool and Primary Scales of Intelligence-Fourth Edition (WPPSI-IV), children’s intelligence quotient (IQ) was evaluated at 4-year-old. Detailed anthropometrics and BP measurements and echocardiography were conducted during follow-up. Multivariable linear regression models and restricted cubic spline were applied to estimate the association between individual BP, LV structure parameters and IQ scores. Results: There was no significant association found between cognitive function and LV structure in preschool-aged children, while higher BP levels was found to be correlated with lower scores in cognitive function. Children in the elevated BP and non-LVH group tended to have lower full-scale IQ (FSIQ). In detail, children with elevated BP tended to have lower scores in FSIQ (β: -2.95, 95%CI: -4.65, -1.25), processing speed index (β: -1.77, 95%CI: -3.41, -0.14), working memory index (β: -2.79, 95%CI: -4.70, -0.88) and visual spatial index (β: -2.64, 95%CI: -4.74, -0.55), and these associations were independent of LV structure. Conclusion: Higher BP levels was related to poor cognitive development during childhood as early as four, while LV structure alteration was not. The associations between BP and children’s decreased cognitive function was independent of LV structure.

The relationship between digit ratio (2D:4D) and intelligence levels in specific learning disorders

BackgroundHigher prenatal testosterone exposure regulates brain development and affects learning and intelligence directly. The digit ratio (2D:4D) is regarded as an indicator of prenatal testosterone exposure. This study aims to investigate the 2D:4D ratios and intelligence levels in individuals with specific learning disorders (SLD) and compare the ratios with healthy subjects. MethodsThe study included a total of 117 patients diagnosed with SLD and 67 healthy controls. We measured the 2D:4D ratios and administered the Wechsler-Intelligence Scale for Children-Revised to assess intelligence quotient (IQ) scores in the SLD group. Sociodemographic data was obtained for both patients and healthy subjects and compared in both groups, as well as 2D:4D ratios. ResultsCompared to healthy controls, both-hand 2D:4D ratios were found to be lower in the SLD group. In addition, male and female participants with SLD showed lower 2D:4D ratios in both hands than controls. The total scores on the WISC-R were found to decrease as the right-hand 2D:4D ratios and the age increased in the SLD group. ConclusionOur findings add to the literature examining the influence of prenatal testosterone exposure on learning and intelligence in the SLD sample. Further research in this domain may yield valuable insights into the underlying mechanisms and potential clinical implications for the management of SLDs examining additional variables that could potentially impact alongside the impact of sex hormones on brain development.

Association between maternal metal exposure during early pregnancy and intelligence in children aged 3–6 years: Results from a Chinese birth cohort

ObjectiveMaternal environmental metal exposure is common, but long-term prospective epidemiological evidence of its impact on children's intellectual development is still insufficient. MethodsData on maternal plasma metal levels and child intelligence were obtained for 211 3–6-year-old children from Guangxi Zhuang Birth Cohort. ICP-MS was employed to detect 17 metals, including 7 essential metals (Mn, Fe, Co, Ni, Cu, Zn, Mo) and 10 non-essential metals (As, Rb, Sr, Cd, Sb, Cs, Ba, W, Pb, U), in maternal plasma samples obtained before 13 weeks of gestation during the initial maternity checkup. Child intelligence was assessed using the Wechsler Intelligence Scale for Children-Fourth Edition. The GLM, RCS and mixture models were used to assess the associations of maternal plasma metal levels with child intelligence quotient (IQ) scores. ResultsThe GLM analysis revealed that U had a significant adverse effect on child IQ scores in high-dose exposure groups (−9.236 [-18.644, −4.936], p = 0.006) after adjusting for covariates, while Sb showed a linear adverse effect on children's intelligence in the adjusted model (−4.028 [-7.432, −0.626], p = 0.021). BKMR modeling indicated that overall IQ scores decreased as concentrations of non-essential metals mixtures increased after adjusting for essential metal mixtures, consistent with findings from the WQS (β [95% CI], −8.463 [-14.449, −2.476], p = 0.007) and Qgcomp models (−7.003 [-12.928, −1.078], p = 0.022). Among the non-essential metals, U had the highest negative weight at 37.96%, followed by Pb (23.35%) and Sb (16.91%). Furthermore, potential interactions were observed between metals (Pb and U) and Sb in the study findings. ConclusionReducing exposure to non-essential metal mixtures, especially U, Sb and Pb, during early pregnancy and ensuring adequate intake of specific essential metal elements could be a critical intervention in addressing childhood intellectual impairment.

The trajectory of anxiety symptoms during the transition from childhood to young adulthood is predicted by IQ and sex, but not polygenic risk scores

AbstractBackgroundUnderstanding the factors that determine distinct courses of anxiety symptoms throughout development will better guide interventions. There are scarce data‐driven longitudinal studies, using multi‐modal predictors, investigating the chronicity of anxiety symptoms from childhood to young adulthood, particularly in a middle‐income country.Methods2033 youths (ages 6–14 years [Mean age = 10.4 ± 1.94) at Baseline] were enrolled in the Brazilian High‐Risk Cohort for Mental Conditions longitudinal study, and assessed at three timepoints, between 2010 and 2019, using the Screen for Child Anxiety Related Disorders. Confirmatory Factor Analysis provided input to Growth Mixture Models to identify the best fitting trajectory model. Multinomial logistic regression analyses tested the effects of intelligence quotient (IQ), environmental factors and polygenic risk scores on internalizing symptomatology within trajectory class membership.ResultsThe best model solution identified three classes: high‐decreasing, moderate/low‐stable and low‐increasing symptoms over time. The high‐decreasing class showed a higher incidence of anxiety symptoms at the second time point (Mean age = 13.8 ± 1.93); while anxiety symptoms were highest in the low‐increasing class at the third timepoint (Mean age = 18.35 ± 2.03). Further, lower IQ predicted membership in the high‐decreasing trajectory class (OR = 0.68, 95% CI [0.55, 0.85]), while higher IQ predicted membership in the low‐increasing trajectory class (OR = 1.95, 95% CI [1.42, 2.67]). Finally, females were more likely than males to be in the low‐increasing trajectory class. Polygenic risk scores were not associated with anxiety trajectory class membership.ConclusionRecognizing that anxiety symptoms follow diverse paths over time will allow for more effective intervention strategies. Specifically, interventions could accommodate children for greater anxiety risk in early childhood (i.e., lower IQ) versus late adolescence (i.e., higher IQ). That said, the emotional needs of girls in late adolescence should be monitored, regardless of their cognitive abilities or high achievements.

Evaluation of Sleep EEG Changes in Paediatric Patients with Language Dysfunction: A Follow Up Study

Abstract Background Several case reports and studies have described an association between sleep epileptiform discharges and language dysfunctions. This has been partly confirmed in studies that have investigated the effect of this epileptiform discharges on neurocognitive function. Objectives To screen for sleep-potentiated epileptiform discharges in children with language dysfunction (language delay or regression) and to evaluate the effect of treatment of these epileptiform discharges on language dysfunction. Methods The study was conducted on 93 children with language delay or language regression. Patients were recruited from the pediatric neurology clinic, pediatric outpatient clinic, phoniatrics outpatient clinic and the inpatient neurology ward at the Ain Shams University Children’s hospital, Cairo, Egypt in the period between February 2020 and November 2021. A 90- minute sleep electroencephalography, intelligence quotient level and language age were done for all patients included in the study. Children who had an active electroencephalography with uncontrolled clinical seizures or persistently epileptogenic activity without clinical seizures received treatment according to type of activity then after 6 months they were subjected to follow up electroencephalographyand assessment of intelligence quotient level and language age. Results The enrolled patients were divided into two groups: Group (1) including 28 (30%) patients with either or both of epileptogenic activity and clinical seizures and group (2) including 65 (70%) patients without either epileptogenic activity or clinicalseizures. We found 24 (85.7 %) children in group 1 had clinical seizures with median age of onset 2.5 years (range from 1-8 years). Further in the first group, 21 (85.7 %) of children showed presence ofepileptogenic activity with 10 (47.6 %) of children showed spike and slow wave, 6 (28.6 %) showed sharp wave, 3 (14.3 %) showed continuous spike and wave during slow wave sleep (CSWS), 2 (9.5 %) children showed sharp and slow wave. In our study, levetiracetam was given as first line treatment in patients with active seizures. An add-on therapy was given in patients who were not controlled on one antiepileptic drug. A follow up 90 minutes sleep electroencephalography was done and showed a highly significant reduction in epileptogenic activity with a p value of &amp;lt; 0.001. A follow up language test and intelligence quotient level score were done and showed a highly significant improvement with p value of (0.001 and 0.009) respectively. Conclusion Epileptiform activities with or without epilepsy in children may alter normal language function. Treatment of these epileptogenic activity affect improvement of this language dysfunction. Trial registration: ClinicalTrials.gov I.D: NCT05487521.

Quantifying dilated perivascular spaces in children with sickle cell disease.

Sickle cell disease (SCD)-related neurological effects are particularly devastating. Dilated perivascular spaces (dPVS) are a well-described component of cerebral small vessel disease in older adults without SCD. However, the burden and association of dPVS with neurological complications in children with SCD have not been described. In this study, we used the international consensus criteria to quantify dPVS in the centrum semiovale and basal ganglia in T2-weighted magnetic resonance images (MRI) of children with SCD who were randomized as part of the Silent Cerebral Infarct Transfusion (SIT) trial. We examined the relationship between global and/or regional dPVS burden and presence or area of silent cerebral infarctions, hematological measures, demographic variables, and full-scale intelligence quotient (FSIQ) scores. The study included 156 SIT trial participants who had pre-randomization and study exit MRI. Their median age was 9.6 (5-15) years, 39% were female, and 94 (60%) participants had a high dPVS burden. Participants randomized to the blood transfusion arm and who had a high dPVS burden at baseline had a moderate decline in dPVS score over 36months compared to no change in the observation group. On multivariable logistic regression, intelligence quotient was not associated with dPVS burden. Children with SCD included in the SIT trial have a high burden of dPVS compared to children without SCD. However, dPVS do not appear to have the same pathophysiology of silent cerebral infarcts. Further study is needed to determine both their etiology and clinical relevance.

Etiology of Borderline Intellectual Functioning.

Borderline intellectual functioning (BIF), characterized by intelligence quotient scores between 70 and 85, can lead to challenges in daily life. This review explored the multifaceted nature of BIF by examining the interplay between genetic predisposition, prenatal/perinatal factors, environmental influences, and underlying medical conditions.

Safety and Feasibility of Hippocampal Sparing Cranial Radiation in Pediatric and Adolescent Acute Lymphoblastic Leukemia Patients: A Prospective Study.

Introduction Acute lymphoblastic leukemia (ALL) constitutes a significant portion of pediatric malignancies, with central nervous system (CNS) relapse posing a considerable threat to patient outcomes. While cranial radiation therapy (CRT)has been utilized to mitigate CNS relapse, it is associated with neurocognitive (NC) side effects. This study explores the feasibility and safety of using volumetric arc therapy (VMAT) with hippocampal sparing (HS) during cranial radiation therapy for ALL patients, aiming to reduce these side effects. Methodology This prospective observational study included pediatric and young adult patients with ALL who werein remission. HS was achieved using VMAT, and NC assessments were performed at baseline, six months, one year, and, to a limited extent, four years posttreatment. Results VMAT enabled precise hippocampal-sparing CRT with minimal dose to the hippocampus. Dosimetric analysis revealed that patients receiving 18 Gy had mean doses to planning target volume (PTV) and bilateral hippocampus of 18.9 and 9 Gy, respectively. Those receiving 12 Gy had corresponding doses of 13.3 and 7 Gy, respectively. Conformity and homogeneity indices were 0.9 and 0.1, and no brain relapses were observed among the patients in this study. NC assessments demonstrated no decline in intelligence quotient (IQ) scores over time, while only a subset of patients could be assessed at the four-year mark; telephone interviews suggested no significant cognitive decline. Conclusions This study highlights the potential of VMAT with HS as a promising approach to CRT for ALL patients in reducing the risk of NC side effects. The absence of brain relapses and preservation of NC function are encouraging findings, though larger studies are necessary to establish conclusive evidence.

QOL-35. ANALYSIS ON THE EVOLUTIONARY PATTERN OF COGNITIVE FUNCTIONS IN CHILDREN ON FOLLOW-UP FOR BRAIN TUMORS

Abstract BACKGROUND Long-term cognitive sequelae of paediatric brain tumors are of increasing interest. The role of histology and surgery remains still unclear. Our study aimed to evaluate children cognitive functioning before and after brain tumors surgery, and at the end of additional treatments. METHODS New diagnoses of paediatric primary brain tumors were prospectively assessed. Neurocognitive evaluations were performed at diagnosis (T0), within 7-10 days from surgery (T1) and 12-18 months after the end of treatments (T2). Language, learning and memory, attention, executive functions, visuo-constructional and sensorimotor skills were evaluated at T0 and T1, Intelligent Quotient (IQ) was explored at T0 and T2. RESULTS Twenty-five patients (M:F=15:10, mean age 10.9±3.4 years) were enrolled between January 2019 and December 2022. In comparison to normal values (&amp;gt;7.0), at baseline patients showed major deficits in narrative memory (6.6±3.7, p&amp;lt;0.001) and visuo-spatial memory (copy design tasks: general 6.8±3.9, p&amp;lt;0.001, specific 6.2±3.3, p&amp;lt;0.001, motor 5.2±3.2, p&amp;lt;0.001). At T1 assessment, significant deficits remained in narrative memory (6.2±3.3, p&amp;lt;0.001) and visual-motor coordination (copy design tasks: specific 5.9±3.0, p&amp;lt;0.001 and motor 4.8±4.3 p&amp;lt;0.001); attention and visual-constructional abilities significantly improved (p=0.04 and p=0.001). On the visual construction test, children with high-grade histology scored lower than the low-grade group (Rey- Osterrieth complex figure-copy 5.1±4.4 vs 11.0±4.3; p=0.019). At T2 evaluation children showed persistent deficits in visuo-spatial processing and a possible decline in IQ scores, with lower scores compared with T0 (93 vs 100, p=0.05). CONCLUSIONS Children with brain tumors may present several neuropsychological impairments at diagnosis, particularly those with high-grade diseases. Surgery may have a positive effect on the recovery of some cognitive functions. However, cognitive decline may worsen over time. Baseline and periodic neurocognitive evaluations should be encouraged to identify functional difficulties and to develop a tailored treatment approach for the patient.